Comments (14)

Read the article carefully. The author didn’t “fire” her doctor; her doctor fired her. And not for the reasons that the author alludes to.

Here is why her doctor fired her and her family. The ACA cuts Medicare physicians’ fee by about one-quarter. In addition, exchange plans squeeze doctor’s fees using narrow networks. The ACA also makes millions of lower-middle class individuals eligible for Medicaid, which pays physicians only about half what private insurers pay for the same service.

The author’s doctor basically said that he/she would not practice under those conditions. If the author wanted to continue being treated by her doctor, her family needed to cough up $125 per month as a retainer fee. The author was unwilling (as were an estimated 80% of the doctor’s patients). But the remaining 20% of patients willing to abide by this arrangement will receive better service. That’s how it usually works. The one-quarter to one-fifth of patients who stay with a concierge medical practice love their care.

Great point Devon! Not surprising that even the media are now compelled to report on the negative labor consequences of the ACA. Of course the employer mandate is going to hurt the aggregate employment picture. Economists talk about this as increasing business costs without increasing the marginal revenue product, and the only thing employers can do is reduce labor-hours, layoff workers, raise consumer prices, or invest in non-labor capital. All of these spell trouble for the American labor force, while Obamacare advocates get to blame the “greedy” businesses for their own failures.

What would you expect people under 30 to die of? Alzheimer’s in people under 30 is extremely rare — as is death from heart disease and stroke. In centuries past, one-third or more babies died (mostly) of dysentery or childhood diseases before their 5th birthday. Once they made it that far, they were likely to survive into adulthood. People no longer die of childhood diseases. Food poisoning isn’t a common occurrence now that refrigeration is the norm and food safety regulations government food storage and preparation. Women no longer routinely die in childbirth. Workplace death from unsafe factories is way down. That mostly leaves injury from auto accidents, motorcycle accidents, drug abuse and violence.

All the chatter we are hearing about price transparency appears to be mostly noise. It calls for a dramatic solution. I previously recommended (in this blog) a common-law solution: If a provider did not give you a good-faith estimate before treatment, you don’t have to pay him. That would change things very quickly.